What You Should Know Before Hiring A Medical Billing Advocate

What You Should Know Before Hiring A Medical Billing Advocate Featured

You’ve seen the medical bill and you know something looks off. You’re being charged too much by your provider or you’re unclear as to what you’re actually being charged for. You don’t feel comfortable talking to the billing staff about it, so what do you do? Contact a medical billing advocate! Patient billing advocates look over your medical bills to identify error and negotiate on your behalf. These advocates can reduce what you owe and save you a lot of money, but there are a few things you should know before you hire one.

What exactly does a medical billing advocate do? It’s more than just negotiation skills. Medical billing advocates typically provide an entire process that leads to saving you money. 

  • The advocate looks over your bill, insurance explanation of benefits (EOB), and medical records for accuracy
  • They find errors within your medical bills and negotiate with your medical provider based on those errors to lower your bill. Errors can include over-charges, coding mistakes, and other issues that can accidentally raise your bill.
  • They put together a payment plan for your provider that fits your budget. That includes specialists and hospitals too! 

How do I know that I need a medical billing advocate? Ask yourself the following questions:

  • Did you have an unusually large medical bill after a long hospital stay or intense surgery?
  • Did you receive multiple medical bills in the mail from different providers or facilities?
  • Do you have a family member that receives medical bills on a regular basis?
  • Have you unsuccessfully tried to negotiate charges with your provider on your own?
  • Does your medical bill list charges that you feel you should not pay for, based on the service provided to you?

 If you answered yes to any of these questions, and feel uncomfortable speaking with your provider on your own, you should consider hiring a medical billing advocate! 

How much money can a billing advocate actually save me? The dollar amount you can expect to save really depends on the type of services provided to you. However, the average rate is around 30%. Here are some examples of the typical savings you can expect within certain specialties:

  • Emergency Departments and Surgery Centers – 10-80%
  • Radiology (Imaging) – 20-40%
  • Anesthesia Treatment – 15-30%
  • Dialysis Treatment – 5-50% 

Do medical biling advocates work for free, or will I have to pay for their services? This is a question you’ll want to ask every advocate upfront! Compensation depends on the individual and the organization they work for. Some advocates are paid hourly on average between $30-$50 per hour. Some advocates take a percentage of what they save you, anywhere from 15-20%. Remember, this is a much better solution compared to trying to pay the bill in full. In the event that the advocate is unsuccessful in saving you money, you owe them nothing in terms of compensation.

How do I know which biling advocate is right for me? There is no formal training behind medical billing advocacy, so try to choose based on experience. If you think you’re being overcharged for an MRI, you should choose an advocate that has worked with a sizeable number of patients with radiology-related bills. If you have an elderly family member that you believe is being charged unfairly for services, consult an advocate that has experience with bills relating to chronic illness or advanced age. 

Where can I find a billing advocate? There are multiple sources you can use to find the right medical billing advocate for you

Where do I begin? How do I apply to work with a medical biling advocate? Depending on the organization you decide to work with, the process will vary. Sometimes, you can submit your application on the organization’s website. For others, you’ll have to mail or fax your application. That information should be provided to you on any company’s website. Also, remember that there’s an expectation to disclose all of the expenses you have incurred – you’ll need to provide every bill and all the details about the services that were provided to you i.e. procedure(s) provided, provider name, when and where the procedure(s) was performed, etc. Your negotiator will need a crystal clear understanding of exactly why you’re in need of his or her services, so provide as much detail as you possibly can.

 If you feel like you’re being unfairly charged for medical services, you’re not alone! Hopefully this article brings you closer to peace of mind and more money into your pocket. 





Jenna Tropea

A social media and marketing junkie, Jenna Tropea covers a range of topics from healthcare technology to policy and regulations. Jenna received her MBA from Clemson University and enjoys discovering and sharing the latest news in health IT breakthroughs.